On Thursday, the Ohio House of Representatives passed a "fetal heartbeat" bill which would ban abortions as soon a fetal heartbeat is detected which can be as early as 6 weeks into a pregnancy. The bill now moves on to the Ohio Senate. The Ohio legislature passed a similar bill in 2016. However, former Republican Gov. John Kasich vetoed the bill because it is unconstitutional. Ohio governor-elect Mike DeWine has said that he will sign the bill if passed.

In the wake of fetal personhood, or similar, ballot measures being proposed and passed throughout the U.S., it's important to look to other countries where abortion is criminalized to see the effects of living in a world where abortion and those who seek or perform them are punished.

A survivor of habitual sexual abuse by her grandfather has been imprisoned in El Salvador since April 2017 on charges of attempted murder. Last April, Imelda Cortez, then 20-years-old, gave birth to a child fathered by her rapist. She experienced intense pain and bleeding before the birth, which caused her mother to bring her to the hospital. The doctors there suspected an attempted abortion and called the police. The baby was born alive and well, but Imelda has never been able to hold her, as she's been in custody since her time in the hospital last year.

Authorities conducted a paternity test, which confirmed Imelda's claims of rape, yet her grandfather has not been charged with any crime. Imelda's criminal trial began this week and a decision from a three judge panel is expected next week.

Abortion is illegal in all circumstances--no exceptions--in El Salvador. The strict ban has led to severe persecution of pregnant people throughout the country, often most heavily affecting impoverished, rural-living people. Most people accused of abortion simply experienced a pregnancy complication, including miscarriage and stillbirth.

This pattern of prosecutions targeting a particular demographic suggests a discriminatory state policy which violates multiple human rights, according to Paula Avila-Guillen, director of Latin America Initiatives at the New York based Women’s Equality Centre. Cortez’s case is a stark illustration of how the law criminalises victims.

Abortion has been criminalized in El Salvador for 21 years. While a bill was drafted nearly two years ago--with public and medical support--aiming to reform the system and relax the ban to allow the option of abortion at least in certain cases (for example, rape, human trafficking, an unviable fetus, or threat to a pregnant person's life), it remains stuck in committee and is not expected to make it to vote.

Two out of three states that were considering adding restrictions on abortion approved ballot measures on Tuesday.

Alabama and West Virginia approved measures that would significantly restrict access to abortion care if Roe v. Wade is overturned by the Supreme Court. Another measure in Oregon failed.

In Alabama, voters approved an amendment to the state’s constitution that would effectively give a fetus the same rights as a person who has been born. Amendment 2 would add language to the Alabama constitution that would “recognize and support the sanctity of unborn life and the rights of unborn children.”

Abortion rights advocates worry this could make it more difficult for women to get access to abortion through the courts or that it could lead to criminalizing contraception or in-vitro fertilization. Other states have passed similar amendments, but Alabama’s is especially restrictive and does not include exceptions for incest, rape or life of the mother.

In West Virginia, the “No Constitutional Right to Abortion Amendment”, or Amendment 1, would explicitly change the state’s Constitution to read “nothing in this Constitution secures or protects a right to abortion or requires the funding of abortion.”

The amendment would effectively mean that people in West Virginia do not have a right to abortions with Medicaid funding. Medicaid in the state currently covers abortions considered medically necessary, but the amendment does not include such an exception.

Finally, in Oregon, Measure 106 would have prohibited public funds from paying for abortions, except in the cases of rape, incest or threats to the pregnant person’s health. Voters in the state rejected the measure on Tuesday. The measure would have meant that public employees and people on Medicaid could not get coverage for abortion care in the state.

Two new surveys reveal a remarkable shift in how important the issue of abortion is to Democrats and Republicans ahead of the 2018 midterm election this Tuesday, November 6.

A recent PRRI survey found that nearly half (47 percent) of Democrats said abortion is a critically important issue to them personally; 40 percent of Republicans said the same. That represents a dramatic swing since 2015, when 36 percent of Democrats and 43 percent of Republicans said abortion was a critical concern. Democrats are almost twice as likely today as in 2011 to rate the issue as critical.

Meanwhile, a recent Pew poll showed that abortion is a far more central voting concern for Democrats today than it has been at any point in the last decade — 61 percent of Democratic voters said abortion is very important to their vote this year. In 2008, only 38 percent of Democratic voters said the same.

Brett Kavanaugh’s confirmation to the Supreme Court appears to have elevated the perceived threat level to the right to abortion. A PRRI poll conducted during Kavanaugh's confirmation process found that nearly two-thirds of Democrats believed that Kavanaugh would vote to overturn Roe v. Wade. Another likely reason for the rising concern among Democrats, Cox reasons, is the years-long campaign to curb abortion access at the state level.

Cox also finds that reproductive health care has taken a more central place in the Democratic agenda as women, particularly young women, have taken on more prominent roles in the party. Many Democratic women, Cox writes, see abortion access as inextricably linked to the financial security and autonomy of women.

However, polls show that when most Democrats make voting decisions, they still weigh the issue against a host of competing concerns, such as other health care issues and the environment. It is not a litmus-test issue for most Republican or Democratic voters. Only 21 percent of Republicans and 30 percent of Democrats say they would only ever support a candidate whose views on abortion align with their own, according to a PRRI poll.

Democrats are likely to continue to prioritize abortion so long as its legal status appears to be threatened and access to it is limited. This may mean that fewer Republicans campaign on their explicit opposition to abortion, at least in the short-term. Conservative Christians, who have worked for decades to overturn Roe, have been conspicuously tight-lipped about abortion in recent months, indicating that they are worried about the possible political fallout of discussing their views. The 2018 election will show if that strategy comes too late and the abortion issue has given Democratic voters another reason to head to the polls.

Midterm voting is already well underway throughout the country with election day officially falling on Tuesday, November 6. While the citizenry waits to see whether Republicans or Democrats will next control their state legislatures, next week's elections will also implicate specific issues in addition to deciding our leaders. Abortion rights are on the ballot in Alabama, Oregon, and West Virginia.

Alabama's ballot measure proposes "personhood" rights for fetuses, which could criminalize access to certain contraceptives or in vitro fertilization. The measure, if passed, would act as a "trigger ban"and would completely outlaw abortion under the circumstances of a post-Roe world. Similar ballot measures have previously been proposed--and failed--in Colorado, Mississippi, and North Dakota. Republican legislators in Alabama want the state Constitution to explicitly elevate the rights of unborn fetuses over any right to an abortion. The Amendment does not include any exceptions to a prohibition on abortion--not even in the cases of threat to the mother's life.

In West Virginia, the No Constitutional Right to Abortion Amendment also aims to update their state Constitution. Lawmakers wish for the text to explicitly assert that nothing in the instrument protects the right to or funding for an abortion. The state already has a pre-Roe abortion ban that remains on the books, which would enter into force should Roe v. Wade be overturned, criminalizing abortion and punishing providers with imprisonment. The new Amendment proposal focuses on eliminating Medicaid funding for abortions. Medicaid currently covers "medically-necessary" abortions in West Virginia. While the Amendment does include exceptions for cases of rape, incest, fetal anomaly, or threats to life, opponents are particularly concerned that the new restriction would disproportionately harm low-income patients who do not qualify for exemptions.

Finally, the proposal in Oregon, called Measure 106, "would prohibit public funds from paying for abortions in Oregon except in cases of rape, incest, ectopic pregnancies, or a threat to the pregnant person’s health." Public employees and people on Medicaid would lose access to abortion as well. This measure would specifically override the Reproductive Health Equity Act, which Oregon passed last year to guarantee cost-free access to abortion and reproductive health services.

In the era of a Kavanaugh Supreme Court, advocates are particularly zealous about preemptively protecting abortion access on the state level, and those involved in these three states' campaigns are no exception.

Abortion will become legal in Queensland after the Australian state’s parliament voted to support new legislation and erase a 119-year-old “morality” section of its criminal code.

Loud cheers in the legislative assembly chamber on Wednesday evening brought an end to a 50-year struggle by women’s groups in a state once notorious for its conservative politics.

Abortion was codified as an “offence against morality” under the Queensland criminal code, which the current premier, Annastacia Palaszczuk, said in parliament was written before women had the right to vote.

Both the Labor and the Liberal National party granted their members a conscience vote, and most expected a close result. In the end, the laws passed 50-41.

Abortion will become legal until 22 weeks gestation, and after 22 weeks with the approval of two doctors. Safe access zones will restrict protesters and people who harass patients from coming within 150 meters of abortion clinics. Doctors under the law may refuse to treat a woman on moral grounds, but will also be legally required to refer patients to another medical practitioner.

Children by Choice, the all-options counselling service, was at the forefront of debates about abortion in Queensland for decades.

“Children by Choice has been fighting for this important reform to cruel and archaic laws since 1972 and we are so proud of all of the people who have advocated on behalf of Queenslanders who couldn’t advocate for themselves,” Children by Choice manager Daile Kelleher said.

The anti-abortion group Cherish Life put out a statement vowing to continue its campaign and to target Queensland members of parliament who supported the new laws at the next state election.

On Thursday, The Atlantic published a piece surveying nations that maintain bans on abortion, in light of the belief that abortion is expected to become further restricted with Brett Kavanaugh on the Supreme Court.

Khazan writes that legal experts believe the majority-conservative court likely won’t overturn Roe v. Wade, but rather will chip away at abortion rights by narrowing the circumstances in which a woman can obtain the procedure. Still, abortion rights advocates fear that increasing restrictions will force low-income women into desperate situations and increase the rate of self-managed abortion, in which interest has spiked in recent years as access to safe and legal abortion erodes in many states.

If other countries provide guidance, Khazan writes, "abortion restrictions won’t reduce the number of abortions that take place." According to the Guttmacher Institute, abortion rates in countries where abortion is legal are similar to those in countries where it’s illegal, and in countries where abortion is illegal, botched abortions still cause about 8% to 11% of all maternal deaths, or about 30,000 deaths each year.

But, Khazan observes, doctors have gotten better at controlling bleeding in recent decades, and there has also been a major revolution in how clandestine abortions are performed thanks to medication abortion (mifepristone and misoprostol).

Mifepristone and misoprostol have made Brazil's rate of treatment for severe complications from abortion decline by 76 percent since 1992. In Latin America overall, the rate of complications from abortions declined by one-third since 2005.

Meanwhile, in El Salvador abortion is illegal, but one in three pregnancies still ends in abortion. Many women there who want to abort their pregnancies, Khazan finds, obtain misoprostol on the streets.

"Those who have internet access and reading skills can look up information about how to take it properly."

Federal prosecutors in El Salvador are known to visit hospitals and encourage doctors to report to authorities any women who are suspected of self-inducing their abortions. But because federal prosecutors are only visiting public hospitals and not private hospitals, poor women are much more likely to be reported for their illegal abortions than rich women.

In Brazil, where abortion is also illegal, about 250,000 women are hospitalized from complications from abortions, and about 200 women a year die from the complications. About 300 abortion-related criminal cases were registered against Brazilian women in 2017.

In Ireland prior to the repeal of its criminal abortion ban, women would travel to England to get the procedure—often using a fake English address so they could get the procedure for free under the United Kingdom’s National Health Service. Others, Khazan writes, "would order abortion pills from Women on Web, a Canada-based service that ships the pills to women in countries where abortion is illegal."

Whether a self-induced abortion is dangerous likely depends on where a woman gets her pills and what kind of information is available to assist her. Irish women’s outcomes were better than the Brazilian women’s possibly because they had access to regulated services like Women on Web. Brazilian customs officials, meanwhile, confiscate shipments of medication abortion into the country, forcing women to turn to the black market.

The American market for abortion drugs will boom under a Kavanaugh Supreme Court, says Michelle Oberman, a Santa Clara University law professor, but it will also become more difficult to penalize abortion providers for illegal abortions, since with medication abortion there is no doctor, only the woman. In that case, Oberman says, “everything I saw [in Ireland] will happen here”: the hospital reports, the prosecutions, the jail sentences.

Many states have already prosecuted women for doing drugs while pregnant or for otherwise allegedly harming their fetuses. Overwhelmingly, those punished tend to be poor women and women of color.

The Irish parliament is debating legislation to legalize abortion services nationwide. It is the first time the Irish parliament has addressed the issue since the Eighth Amendment - a near total constitutional ban on abortion - was removed by referendum in May.

Irish Health Minister Simon Harris hopes abortion services will be available in Ireland starting in January.

Known as the Regulation of the Termination of Pregnancy Bill, the legislation allows for abortion services to be provided "on demand" up to the 12th week of a pregnancy, and in the case of a fatal fetal abnormality or where the physical or mental health of the mother is in danger.

Harris has said that abortion would be made available free of charge.

Introducing the bill in the Irish assembly, Harris said the referendum was a resounding affirmation of support for right of women to make choices about their lives.

"More on women's health, women's equality, more on continuing to shape an inclusive and equal society," said Harris.

Separate legislation will be introduced at a later date to allow for "safe access" zones - designated areas that prevent protests around abortion providers.

The Irish government must work with doctors to implement services and provide training and support. Dr. Mary Favier, founder of Doctors for Choice, told the Irish Times that planning for abortion by the Department of Health had been "a shambles."

"There's been no clinical lead appointments. There's been no technical round tables established. There's been effectively no meetings held," she said.

Mike Thompson, a general practitioner in east Cork, told the BBC that the government's proposed timeline of January 2019 was "ambitious" and "challenging."

"Unless there is a clear and robust guideline, no GP will provide the service. It has to be safe," Dr. Thompson said.

Earlier, anti-abortion doctors said they did not wish to be forced to refer a pregnant woman seeking a termination to another doctor. A bill allowing for doctors to opt out of providing a medical or surgical abortion if they do not wish to perform the procedure was introduced in the Irish parliament earlier this year. The legislation requires that doctors refer a woman seeking an abortion to another doctor who will perform the abortion.

The health minister said that conscientious objection was one thing, but refusing to refer women wishing to terminate their pregnancies to other doctors was quite another.

It is unclear how a small number of doctors objecting to providing abortion care will affect the rollout of abortion services in Ireland.

A Federal court in Kentucky ruled a 1998 state law aimed at limiting abortion clinics unconstitutional.

The law requires abortion clinics to have written transfer agreements with ambulance services and hospitals, often referred to as "transfer and transport" requirements. Even though the state's last abortion clinic (and a plaintiff in the lawsuit) has been able to maintain the licensure required by the law--and so stay open--the court agreed with the clinic's argument that Kentucky Gov. Matt Bevin (R) has used the law as a tool to try to cut off abortion access.

Judge Greg Stivers ruled:

The court has carefully reviewed the evidence presented in this case and concludes that the record is devoid of any credible proof that the challenged regulations have any tangible benefit to women’s health. The regulations effectively eliminate women’s right to abortions in the state. Therefore, the challenged regulations are unconstitutional.

The judge affirmed that “the challenged regulations are not medically necessary and do absolutely nothing to further the health and safety of women seeking abortions in the Commonwealth of Kentucky." The decision is expected to be appealed in the 6th Circuit.

A federal court in Virginia also ruled last week that that a similar lawsuit challenging the state's anti-choice licensing and oversight restrictions can move forward.

New York legalized abortion in 1970, becoming the second state in the United States to broadly legalize abortion care and the first state in the nation to legalize it for out-of-state residents.

At the time, the law was seen as liberal, but no longer, according to legal scholars and experts. As confirmation hearings for Brett Kavanaugh proceed in the U.S. Senate and the fate of Roe v. Wade hangs in the balance, New York's abortion laws have received increased attention at the state and local level.

"There has been a dramatic increase by states in the last decade to try to test the boundaries of the nation's abortion law, and it seemed to be in anticipation of changes on the Supreme Court," said Andy Ayers, director of Albany Law School's Government Law Center.

Though a common assumption is that New York is generally safe from federal rollbacks on progressive issues, a policy brief authored by Ayers and published last week by Albany Law School and the Rockefeller Institute of Government highlights exactly why that might not be the case when it comes to abortion rights.

Under New York penal law, abortion is technically a crime. The 1970 law that legalized abortion simply made the procedure a "justifiable" crime under two specific circumstances: when it is performed within 24 weeks of conception or when it is performed to save a woman's life. The law contains no health exception or any other exception (such as when the fetus is nonviable) from the 24-week restriction. However, the Supreme Court later ruled in Roe and in Planned Parenthood v. Casey that denying a health exception or forcing women to carry nonviable fetuses to term constitute unconstitutional restrictions on access to abortion care.

In 1994, the New York Court of Appeals wrote that "the fundamental right of reproductive choice, inherent in the due process liberty right guaranteed by our state constitution, is at least as extensive as the federal constitutional right," and went on to cite both Roe and Casey.

"In lawyer terms, this was 'dicta,' meaning non-binding," said Ayers, who is an adviser to the Rockefeller Institute's Center for Law and Policy Solutions. "But to me, it's very, very hard to imagine that our Court of Appeals would find it permissible to restrict abortion in a way that Roe would not have allowed."

Although legal experts agree it's unconstitutional for New York to deny late-term abortions to women to protect their health or when the fetus is nonviable, those exceptions remain a gray area to some medical professionals.

The law governing abortion in New York exists within the state's penal code, meaning violators could face criminal punishment rather than civil liability. Some doctors in New York have urged some patients to seek a late-term abortion in another state.

The Reproductive Health Act, a bill that was introduced in the state Legislature in 2017 to bring New York's abortion law in line with Roe and Casey, would lessen this effect by moving abortion statutes out of state penal law and into the state's public health law. It would also expand the types of medical professionals allowed to perform abortions to include nurse practitioners and physician assistants.

As President Donald Trump prepared to announce Brett Kavanaugh as his Supreme Court nominee this summer, and amid pressure on the left from Democratic primary opponent Cynthia Nixon, Governor Andrew Cuomo spoke out against Republican state senators who have refused to pass the bill.

Other states have had better luck amending their abortion laws as the ideological makeup of the Supreme Court faces its most significant shift since the Second World War. Massachusetts recently amended its laws to bolster abortion protections, while at least fifteen states have passed laws in recent years that would prohibit abortion should the Supreme Court overturn Roe.

"If a significant number of other states start prohibiting abortion or making it hard to access," Ayers said, "we may see people come into New York to get abortions again, just like they did in the '70s."

This past Thursday, the New York City Council Committee on Women, chaired by Council Member Helen Rosenthal, held a hearing on the current status of reproductive rights and access to abortion services in New York City. The Committee heard Council Resolution 84, introduced by Public Advocate Letitia James, Council Member Rosenthal, and Council Member Justin Brannan, which urges the State Legislature to pass, and the Governor to sign, the Reproductive Health Act. Abortion rights advocates testified at the hearing, including Cynthia Soohoo, Co-Director of the Human Rights and Gender Justice Clinic at CUNY School of Law. More information about the hearing, including video of the hearing, can be found here.

Women from Northern Ireland who travel to Britain for abortion care may not be able to access abortion pills. On average, each week 28 women travel from Northern Ireland to England for abortion care because, unlike the rest of the UK, the 1967 Abortion Act does not extend to Northern Ireland.

England allows women to take medication abortion at home, but patients may have to prove residency before being able to do so.

Northern Irish Labour MP Stella Creasy has backed access to the pills for women in NI. Speaking in the Commons, she said: "In Scotland there is a residency test for the abortion pill, which if it is copied in England would deny women coming from Northern Ireland this choice of procedure.

"Let's get on and give our Northern Irish sisters the right to access healthcare and abortion at home, just as our sisters around the rest of the UK have."

The Department for Health only has the power to approve English homes as a place patients can legally take the abortion pill, according to Victoria Atkins, the Minister for Women and Equalities. However, Ms. Atkins said the definition of what "home" means is yet to be clarified.

"Officials are working with the Royal College of Obstetricians and Gynaecologists to determine protocol which will set out criteria for which places should be covered by the term 'home'... We will look at how the (early abortion pill) schemes are working in Scotland and Wales and learn from the experience there."

Northern Ireland is the only part of the United Kingdom where abortion is illegal in most circumstances. Previous attempts to change the law were blocked within the Northern Ireland Assembly, but there may now be enough support among Assembly members to overturn the ban. However, the devolved NI government has not sat since power-sharing collapsed in January 2017.

In June, UK Supreme Court judges said that Northern Ireland's abortion law violates human rights and called the current ban "untenable."

Ms. Atkins said: "We call upon those representatives in Northern Ireland to get their act together and get the Assembly working again so that Northern Ireland people can make their decision."

After 16 hours of deliberation, Argentina’s Senate narrowly rejected a bill to legalize abortion on Thursday, dealing a painful defeat to a vocal grass-roots movement that pushed reproductive rights to the top of Argentina's legislative agenda and galvanized abortion rights activist groups throughout Latin America, including in Brazil and Chile.

As legislators debated the bill into the early hours of Thursday morning, thousands waited outside the Congress Building in Buenos Aires, weathering the winter cold.

Supporters of the legislation, which would have legalized abortion care during the first 14 weeks of pregnancy, had hoped Argentina would begin a sea change in reproductive rights in a largely Catholic region where 97 percent of women live in countries that ban abortion or allow it only in rare instances.

In the end, 38 legislators voted against legalization, 31 voted in favor, and 2 legislators abstained.

Opposition in Argentina hardened as Catholic Church leaders spoke out forcefully against abortion from the pulpit and senators from conservative provinces came under intense pressure to stand against legalization.

While the bill's failure is considered a major setback for the activists who backed it, analysts said the abortion rights movement has already brought change to Central and South America in ways that would have been impossible just years ago.

On Wednesday, demonstrators rallied in support of the Argentine bill in Uruguay, Mexico, Peru, and Chile, where they gathered in front of the Argentine Embassy in Santiago, chanting and wearing the green handkerchiefs that became the symbol of Argentina’s abortion rights movement.

Recently, activists in Argentina scored a victory with the passage of a law that seeks to have an equal number of male and female lawmakers.

"If we make a list of the things we’ve gained and the things we’ve lost, the list of things we’ve gained is much bigger,” said Edurne Cárdenas, a lawyer at the Center for Legal and Social Studies, a human rights group in Argentina that favors legalized abortion. “Sooner or later, this will be law.”

In the region, only Uruguay, Cuba, Guyana and Mexico City allow any woman to have an early-term abortion.

For Argentina, the debate over abortion has tugged at the country’s sense of self. It is the birthplace of Pope Francis, the leader of the world’s Catholics, who recently denounced abortion as the “white glove” equivalent of the Nazi-era eugenics program. Recently, though, the country has begun shifting away from its conservative Catholic roots. In 2010, Argentina became the first country in Latin America to allow gay couples to wed. Francis, then the archbishop of Buenos Aires, called that bill a “destructive attack on God’s plan.”

The organized movement that pushed the failed bill started in 2015 with the brutal murder of a pregnant 14-year-old girl by her teenage boyfriend. Her mother claimed the boyfriend’s family didn’t want her to have the baby. As debates about violence against women on social media grew into wider conversations about women’s rights, young female lawmakers gave a fresh push to an abortion bill that had been presented repeatedly in the past without going anywhere.

In June, the lower house of the Argentine Congress narrowly approved a bill allowing women to terminate pregnancy in the first 14 weeks. Current law allows abortions only in cases of rape or when a mother’s life is in danger. While the measure failed in the Senate this week, it made some inroads: among the senators who voted for it was Cristina Fernández de Kirchner, who as president had opposed legalizing abortion.

“Society as a whole has moved forward on this issue,” said Claudia Piñeiro, a writer and abortion-rights activist in Argentina. “Church and state are supposed to be separate, but we’re coming to realize that is far from the case,” Ms. Piñeiro said as it became clearer that the push for legalization would lose.

If a woman in Lubbock, Texas wants an abortion, the nearest clinic is 308 miles away in Fort Worth, forcing her to take time off from work, pay for travel, and likely arrange childcare to get there. If that same woman is less than ten weeks along, she’s a candidate for medication abortion—which could, theoretically, be completed in the privacy of her home. Texas, however, requires that the outdated FDA protocol for medication abortion be followed to the letter, and so the woman will have to return to the clinic within one to two weeks for a follow-up visit, despite evidence that an in-person follow-up is unnecessary.

So what if she could video chat with a doctor, pick up a prescription from her regular pharmacy, and manage her own abortion with on-call medical support— otherwise known as a telemedicine abortion?

As it turns out, similar services are already available in a handful of states, though they still involve physical visits to an office. A growing body of research suggests that medication abortion could be offered without any in-person interaction at all. It’s a possibility that is already the subject of an intense political debate that is likely to intensify with a Supreme Court more hostile toward abortion rights.

The first U.S. telemedicine abortion program began in Iowa ten years ago. Between 2008 and 2015, four Planned Parenthood clinics in Iowa performed 8,765 abortions via telemedicine. Each clinic followed the same basic protocol: a patient would come into the clinic for an intake appointment, including an ultrasound, and a doctor would review her images and medical history remotely. After talking to the patient via videoconference, the doctor would enter a password to unlock a drawer in front of the patient. Inside, there were two pills. The first pill, mifepristone, the patient took with the doctor still watching. The second pill, misoprostol, she took at home. Within two weeks, the patient returned to the clinic for a follow-up to ensure the abortion was complete.

A study of the Iowa program, which included the records of about 20,000 patients, showed that telemedicine abortion is just as safe and effective as meeting with a doctor face to face. Patients in Iowa were also more likely to have their abortions earlier in their pregnancies after telehealth was introduced.

Planned Parenthood affiliates in ten states currently offer telemedicine abortion. Telehealth services are also offered at a Whole Woman’s Health clinic in Illinois and in Maine at Maine Family Planning. The Iowa program was interrupted after the state passed a law banning telemedicine abortion in 2013, but was reinstated in 2015 when the Iowa Supreme Court ruled that law unconstitutional. Idaho was forced to repeal two laws banning the telemedicine abortion in order to settle a lawsuit with Planned Parenthood in 2017.

Despite these successful legal challenges, nineteen states currently ban telemedicine abortion. Both Oklahoma and Arkansas have tried to ban medication abortion altogether, including remote practices, but Oklahoma’s law was overturned, and a federal judge placed the Arkansas law on hold pending trial.

The Lilith Fund is one of numerous plaintiffs, led by Whole Woman’s Health Alliance, that recently announced a challenge to dozens of abortion restrictions in Texas, including the state’s telehealth abortion ban. Whole Woman’s Health Alliance is leading similar lawsuits in Virginia and Indiana.

Access to telemedicine abortions would be especially beneficial to patients in rural and other underserved areas. That doesn’t mean it will fix all problems of abortion access, of course. Medication abortion is only FDA-approved up to ten weeks of gestation, and some candidates for the procedure still prefer an in-clinic abortion. Medication abortion is a slightly longer process that still requires a follow-up visit.

The procedure—especially with some changes that make it more fully remote—has the potential to dramatically improve access. With special permission from the FDA, Gynuity Health Projects is conducting a study in Hawaii, Oregon, Washington, New York, and Maine that allows patients to receive pills by mail, eliminating the need for doctors to stock them. Mifepristone, pill number one, is regulated under the FDA’s Risk Evaluation and Mitigation Strategies, which means the medication has to be dispensed by a certified prescriber, not a regular pharmacist. While patients in that study still have to get an ultrasound and medical exam, scientific evidence suggests the process could be even simpler, foregoing the ultrasound altogether. Doing so would make the process even more self-determined.

The death of Ingriane Barbosa Carvalho on May 16, a 31-year-old mother of three who underwent an unsafe illegal abortion, illustrates the high stakes of the fight over reproductive rights that is taking place before Brazil’s Supreme Court during a rare two-day public hearing that started this past Friday.

The nation's high court is considering whether Brazil’s abortion laws — which forbid terminating pregnancies with few exceptions, including cases of rape and instances in which the mother’s life is in peril — are at odds with constitutional protections.

The hearing, which continues Monday, is unlikely to lead to the immediate legalization of abortion care, but reproductive rights activists in Brazil hope the hearing will set off a national debate on the issue, draw attention to the risks hundreds of thousands of women take each year as they resort to illegal abortions and ultimately pave the way to overhauling the existing law.

During the first day of arguments, a majority of the 26 speakers argued for decriminalizing abortion. Though the national Ministry of Health did not take an official position on the issue, Maria de Fátima Marinho, representing the ministry before the court, stated that unsafe, illegal abortions create public health challenges, leading to overcrowding of health care facilities as well as preventable illness and death.

The hearing is being held as Brazilian lawmakers take steps to adopt even more restrictive laws and abortion rights groups across the region face a strong backlash after attaining victories.

Brazil’s top court has ruled narrowly on abortion cases in recent years, signaling an inclination to expand access, but it has stopped short of making sweeping legal changes related to the issue.

In March 2017, the Socialism and Liberty Party and Anis, a women’s rights group, filed a petition asking the court to rule that abortion care within the first twelve weeks of gestation should not subject the pregnant person or the abortion provider to prosecution.

They argue that abortion laws written in 1940 violate protections conferred by the 1988 Constitution, including the right to dignity, equal protection, and access to health care.

A ruling in favor of proponents of decriminalization would be the first step toward legalizing abortion in a nation of 210 million people where an estimated one in five women have terminated unwanted pregnancies.

Estimates of the number of abortions performed in Brazil each year range from 500,000 to 1.2 million. Each year, more than 250,000 women are hospitalized as a result of complications from abortions, according to the Brazilian Health Ministry. In 2016, the last year for which official figures were available, 203 women died as a result of illegal and unsafe abortions.

Since 2000, 28 countries and regions have expanded abortion rights. Last year, lawmakers in Chile lifted the country’s total prohibition on abortion, and next week the Senate in Argentina will vote on a bill that could legalize abortion there.

The Supreme Court hearing prompted Ladyane Souza, a lawyer in Brasília, to publicly disclose that she had an abortion two years ago, even though doing so means she could be prosecuted.

“It’s very cruel to submit women to dealing with this all alone, underground,” Ms. Souza, 22, said. “During that time, I wanted very much to talk to my mother, because I felt it would have been easier if my mother knew, if my friends knew, but I was afraid of being prosecuted.”

Ms. Carvalho’s relatives opted to bury her in a cemetery several miles from her hometown after local residents reacted with outrage and scorn to details of her death. They held a low-key ceremony as her remains were deposited in an unmarked grave in a small hillside cemetery.

“I wish she had survived, so she could have been arrested and learned to be responsible,” Ms. Barbosa, her aunt, said.

Maryland House Speaker Michael E. Busch plans to lead a statewide effort to enshrine a woman’s right to safe and legal abortion care in the Maryland constitution, joining other states in attempting to preempt any move by the Supreme Court to erode abortion protections.

The Speaker said he will personally introduce and earn support for legislation asking voters to approve a constitutional amendment, likely in the 2020 presidential election. An amendment would ensure that even if the Supreme Court overturned Roe v. Wade, no legislation outlawing abortion could be passed in Maryland.

Maryland Governor Larry Hogan, a Republican who is anti-abortion, said that that letting voters decide on the issue “sounds like a great idea.” Ben Jealous, his Democratic opponent running to replace Hogan this November, vowed to campaign in support of the amendment.

Abortion opponents and abortion rights advocates believe a strongly worded dissent Supreme Court nominee Brett Kavanaugh issued last fall, in a case involving a pregnant immigrant teenager in federal custody, indicates he would favor more abortion restrictions and might support overturning the federal protections that began with Roe.

Last week, Massachusetts Governor Charlie Baker signed a bill repealing century-old laws that criminalized abortion care. West Virginia and Alabama have initiatives on the ballot this year to clarify that their state constitutions do not protect the right to an abortion.

If Busch succeeds in persuading three-fifths of each chamber of the Maryland General Assembly to approve the constitutional amendment next year, Maryland voters would see it on the 2020 ballot.

Nine states currently have abortion protections in their state constitutions, according to the Center for Reproductive Rights: Alaska, California, Florida, Iowa, Massachusetts, Minnesota, Montana, New Jersey and New Mexico.

Busch said the amendment would insert Maryland’s existing abortion statute into the state constitution. That law was approved by the General Assembly in 1991. After antiabortion groups petitioned it to a referendum, it passed with 61.7 percent of the vote.

The law allows individuals to seek abortion care without interference from the state if the fetus is not viable outside the womb. An individual may also terminate a pregnancy at any point if the fetus has a “genetic defect or serious anomaly” or if an abortion is necessary to protect the health of the pregnant person.

Busch said he will introduce the amendment proposal when the legislature convenes in January and is confident he can find the votes from lawmakers on both sides of the aisle.

Earlier this month, Massachusetts became the first state to formally respond to the possibility of Roe v. Wade being overturned in the world of a two-Trump-nominee Supreme Court. Although abortion is already legal in the state, Massachusetts still has a 173-year-old law on the books banning the procurement of a miscarriage.

The bill is called the NASTY Women Act (Negating Archaic Statutes Targeting Young Women) and passed in a landslide. While abortion has technically been legal in the state since 1981, state legislators were driven to quick action to further protect these rights after Justice Kennedy announced his retirement.

A Masschusetts State Democrat said:

I think people are beginning to realize these are strange times we live in. Nothing is impossible, and we’ve got to have a ‘plan B.’ If these laws are enforced, what do we do? We’re not willing to sit back and say, ‘Well, it’s not going to happen here.’ The word for that is denial.

New Mexico and New York each have efforts underway to protect abortion rights as well.

While some critics accuse the NASTY Women Act and other similar bills of unnecessary political posturing, supporters cite that the rights we may take for granted are not always guaranteed. Rebecca Hart Holder, the president of NARAL Pro-Choice Massachusetts, says "the reality is any state can have a threat to abortion care.”

Three women in Santiago, Chile were stabbed during a march to demand, legal, safe, and free abortion care by a group of hooded attackers who assaulted the protesters. Around 40,000 women marched in the demonstrations.

The three injured women received medical attention and are currently in stable condition.

There is a concerning trend of violence and harassment against pro-choice activists in South America. In Argentina, the country's Senate is debating a bill to legalize abortion within the first 14 weeks. Several videos showing men threatening women for carrying their staple green handkerchief, a symbol of the abortion rights movement in Argentina, have recently surfaced. Some of the women have been threatened with rape.

“This is terrorism; I don’t want to call it any other way. When a group wants to intimidate another to keep them from expressing their ideas freely,” says Macarena Castañeda, spokesperson for the Mesa de Accion por el Aborto, one of the groups leading the fight for access to legal, safe, and free abortion care in Chile.

The hooded attackers also injured a security officer. According to the police, several attackers are currently detained.

In Chile, former military dictator Augusto Pinochet criminalized abortion in all its forms in 1989. That law remained in place until 2017 with the approval of a bill proposed by then-president Michelle Bachelet that decriminalized abortion in three cases: rape, a risk to the mother's life, and disability. Those exceptions only comprise 3% of all abortions in Chile, according to abortion rights groups.

Abortion remains mostly illegal in Latin America. Only in Uruguay and Cuba is it entirely legal, as well as in the Mexican capital of Mexico City.

Demonstrators wearing red cloaks and white bonnets like the characters from Hulu's "The Handmaid's Tale" demonstrated Wednesday in Argentina in favor of legalizing abortion. They silently marched with their heads bowed through the streets of Buenos Aires until they reached the Palacio del Congreso, the Congress building. During heavy rain, one of the demonstrators read a letter by "Handmaid's Tale" author Margaret Atwood, who voiced her support for the effort led by Argentine feminist groups.

Argentina's lower house, the Chamber of Deputies, approved a bill that would legalize abortion in the first 14 weeks of pregnancy. The Argentine Senate will vote on the measure on August 8. President Mauricio Macri has said that despite his personal opposition to abortion, he would not veto the bill if approved by the Senate.

Earlier this year, Atwood clashed with Argentine Vice President Gabriela Michetti, who has said that she is anti-abortion.

Atwood tweeted to Michetti: "Don't look away from the thousands of deaths every year from illegal abortions. Give Argentine women the right to choose!"

Argentina currently allows abortion only in cases of rape or risks to a woman's health, but abortion rights advocates say doctors and judges often block women from carrying out the procedure.

A 2016 report by Argentina's health ministry estimated that between 370,000 to 522,000 Argentine women undergo illegal abortions each year. Thousands of women are hospitalized for complications.

The report found complications from unsafe, illegal abortion as the main cause of maternal death in Argentina.

Last month the Trump administration proposed a ruleprohibiting the granting of federal Title X family planning funds to family planning providers that also perform abortions. The so-called “Domestic Gag Rule” would create new, unnecessary barriers for patients seeking access to birth control and other services from their trusted reproductive health care providers. In addition, the rule would prevent doctors and nurses across the country who receive federal funding from referring patients for safe, legal abortions.

While the new rule is scheduled to go into effect immediately upon publishing of the final rule, the Department of Health and Human Services (HHS) is required to take public comments into consideration before making the rule permanent.

The Center for Reproductive Rights has posted links to assist those interested in sending comments which provide draft language and templates.

Send a comment to HHS opposing the proposed rule through the Center for Reproductive Rights website using the draft language linked here.

Submit a comment on behalf of your organization urging HHS to rescind the rule. A template is available here. If you need support coordinating the ask within your association or developing a comment, please do not hesitate to reach out to the Lawyers Network team at lawyersnetworkinfo@reprorights.org.

Despite concerns for the future of reproductive rights in the imminent wake of Justice Kennedy's retirement, reproductive rights advocates secured a victory in Iowa last week when the Supreme Court of Iowa struck down a 72-hour waiting period imposed on women seeking abortions.

"The vast majority of women have made their decision by the time they present for care so the laws [mandating waiting periods] do not lead women to change their minds, Dr. Sarah Roberts, an abortion waiting period researcher who works as an associate professor at the University of California, San Francisco, tells Bustle. "They really just lead to increases in financial costs and increases in delay and also some increases in emotional distress along the way."

The Iowa Supreme Court found the restriction a violation of the state Constitution. Dr. Sarah Roberts, an abortion waiting period researcher who works as an associate professor at the University of California, San Francisco, found that imposed wait periods actually lead to even greater delays in care as well as substantial increased costs for the women.

The ACLU of Iowa and Planned Parenthood of the Heartland are also involved in a lawsuit against the state's "heartbeat law," which bans abortion after 6-weeks, the time at which a fetal heartbeat can sometimes be detected. A District Court judge temporarily blocked the law, but if it goes into effect, some women may not have any option for abortion at all, as many don't find out they're pregnant until after six weeks.